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1Copyright © Allyn & Bacon 2004
Kübler-Ross: Stages of Dying (Grief)� Denial
� Learning of the terminal illness, the person denies its seriousness.
� Anger� Anger at having to die without doing all one wants to do
� Bargaining� Attempts to bargain for extra time
� Depression� When denial, anger, and bargaining fail, the person becomes depressed.
� Acceptance � State of peace about upcoming death
Copyright © Allyn & Bacon 2004
3Copyright © Allyn & Bacon 2004
Evaluation of Kübler-Ross's Theory
� Not a fixed sequence
� Not all people display each stage.
� Stages are coping strategies that anyone
may use in the face of a threat.
� Too limited; dying people react in many
other ways.
� Dying patients' feelings are removed from
the contexts that grant them meaning.
Copyright © Allyn & Bacon 2004
Hospice Approach
� Comprehensive support for dying
and their families
� Family and patient as a unit
� Team care
� Palliative (comfort) care
� Home or homelike
� Bereavement help
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Forms of Euthanasia
Medical staff end life without
patient’s consentInvoluntary
Active
• Medical staff provide means for
patient to end own life
• Controversial
Assisted
Suicide
Medical staff or others act to end
life at patient’s requestVoluntary
Active
• Withdraw treatment
• Advance medical directivesVoluntary
Passive
Copyright © Allyn & Bacon 2004
7Copyright © Allyn & Bacon 2004
Voluntary Passive Euthanasia� Life-sustaining treatment is withheld or withdrawn.
� Advance medical directive
� Written statement of desired medical treatment for the
incurably ill
� Living will
� Treatments a person does or does not want in case of a
terminal illness, coma, or other near-death situation
� Durable power of attorney for health care
� Appointment of another person to make health care decisions
� Health care proxy
� Substitute decision maker (if a patient failed to provide
an advance medical directive while competent) 8Copyright © Allyn & Bacon 2004
Voluntary Active Euthanasia� At patient's request, doctor acts to end suffering� Supporters
� believe it is the most compassionate option for terminally ill.
� Opponents � stress the moral difference between letting die and killing.
� argue that involving doctors in taking the lives of suffering patients may impair trust in health professionals.
� Legalizing this practice could lead to broadening euthanasia.
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Copyright © Allyn & Bacon 2004
Assisted Suicide
� Doctor provides drugs for patient to use
� Legal in few nations, only in Oregon in
U.S.
� Few use
� .1% in Oregon
� Highly controversial
� About half disapprove
� Some find option comforting10
Copyright © Allyn & Bacon 2004
Bereavement, Grief, Mourning� Bereavement
� Experience of losing a loved one by death
� Grief (Griefstricken)
� Intense physical and psychological distress
� Mourning
� Culturally specified expression of the
bereaved person's thoughts and feelings
